Journal of Infectious Diseases & Therapy
Open Access

Abstract

Introduction & Aim: Hemoperfusion with adsorption filter is considered to potentially improve the clinical outcomes in septic patients. However, little is known about the effect of anti-inflammation and immune-regulation by this device in traumatic field. The aim of this study is to evaluate the efficacy on early application of adsorption filter in swine trauma model. Method: Blunt thoracic injury and shock was experimentally made in 10 pigs. Traumatic shock were treated with goal direct therapy based resuscitation (control group, n=5) or plus hemoperfusion with polymyxinâ�?�?B adsorption filter (HP group, n=5). Hemoperfusion was started at hour 1 after induction of traumatic shock. Blood samples were taken from the animals at baseline, 1 and 7 hours after shock. For anti-inflammatory evaluation, cytokines such as TNF-�?±, IL-6 were measured by ELISA method and for immunologic analysis, immune cell activities (T lymphocyte subsets, monocyte and natural killer cell) were evaluated with flow cytometry analyses (CD3, CD4, CD8, CD14 and CD56). Results: Median body weight was 33.1 kg (31.7-38.4 kg). Cytokine study demonstrated that TNF-�?± and IL-6 were reduced in HP group after 6 hours of hemoperfusion. However, a progressive increase was detected in control group. In activities of T cell lymphocytes subsets (CD3, CD4 and CD8), there was no significant difference between two groups; however, the activities of monocyte (CD 14) and natural killer cell (CD56) were attenuated at 6 hour in HP group, compared to the control group (p<0.05). Conclusions: We suggest that the hemoperfusion with adsorption filter should have a positive anti-inflammatory effect in early phase of traumatic injury. On the other hand, a negative immune-modulation effect might exist by alleviation of innate immune cell activity. However, further investigation will be needed.

Biography

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